Introduction to the Wrist, Hand and Thumb Anatomy
The wrist is a complex joint that bridges the hand with the forearm. It is made up of a collection of bones: two long bones called the radius and the ulna, eight carpal bones and the base of the metacarpal bones. Below the metacarpal bones are the phalange bones, of which there are 19 in total.
As well as the bones in your wrists there are also many muscles, tendons, ligaments and nerves that help you move your hand and wrist and give it stability and feeling.
Some problems with the wrist and hand occur due to injury. Other problems occur as a result of the normal ageing process, or “wear and tear”.
Wear and tear can occur in soft tissue and joints; the wrist joint, the joint at the base of the thumb, the small joints of the hand and fingers and even in the tendons in the hand. Wear and tear is normal and can be considered as the ‘grey hair’ of joints and tendons. Whilst your joints may have wear and tear, this does not necessarily mean you will have pain. However, when pain is an issue it can make day to day activities more difficult.
Diagram 1: The Anatomy of the Wrist, Hand and Thumb
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What can I do to help my wrist, hand or thumb pain?
The good news is that a lot of hand and wrist problems can settle or improve with advice and exercise. It can take up to 12 weeks in some cases.
Try not to worry
It is only natural to feel worried. However, feelings such as worry, anxiety and fear, or negative expectations about treatment are barriers in preventing people recover and /or manage their problem.
Painkillers
A range of different medications are available to help reduce your pain to allow you to move more comfortably. Pain control can help your rehabilitation progress and does not just “mask” your pain.
If you are unsure of what medication you can take, speak with your local pharmacist, practice nurse or family doctor (GP) for guidance. Do not exceed the daily allowance of these medicines even if your pain is high and always consult a health professional prior to taking any new medication. It is important that if you are prescribed medication that you take them regularly and at the recommended dose (see medication packet for details). All medicines can cause side-effects, particularly if they are not used as prescribed. Side-effects range from common to uncommon and vary from person to person. Information on possible side-effects is available on the leaflet inside the packaging of your medication. It is important to speak to your local pharmacist, practice nurse or GP who may be able to change the dose or the medication itself to something that is more suitable.
Heat/ice
A hot water bottle or ice pack (such as a bag of ice cubes) can also be used regularly to help control pain in the early stages.
If using ice, wrap the ice pack in a damp towel and apply to the painful area for up to 10 minutes every two hours. Be careful to keep a close eye on your skin when using ice and if you experience any pain or significant discomfort remove it immediately.
If you are using heat, wrap the warm compress in a towel and place it on the painful area for up to 20 minutes every two hours.
If you have any concerns about the sensation or feeling on the skin where you are placing either ice or heat, ask a GP to assess this before following this advice.
If for any reason you feel there may be an infection in the area please seek advice from a local pharmacist or GP prior to carrying out this advice.
Corticosteroid injection
Steroid injections can provide pain relief for a single troublesome joint, by reducing the inflammation in the joint. Steroid injections are not given for osteoarthritis of the fingertip joints but are sometimes considered for the other finger joints and the base of thumb if appropriate. These injections carry a risk, they are not a cure and they do come with some side effects. For these reasons you may be advised to try alternative measures first with the aim of more lasting relief and to help protect your wrist and hand over a longer period.
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Activity modification
Looking at what tasks cause pain in the day and considering how you could do these differently. Pacing the activities that cause pain by taking more regular breaks, or, resting from the task for a while (see activity modification and advice section).
Exercise
Gently exercising the joints through their full range of motion and maintaining the strength of the hands (see exercises for the hand, wrist and thumb section). Click HERE for Exercises
Splinting
Using a splint or support whilst performing activities that normally cause pain or using them at night if appropriate may help to reduce symptoms.
General health
Your mental, emotional and physical health and wellbeing is vital in your recovery. Many factors can impact on your wrist and hand pain; giving up smoking, losing weight, increasing your fitness, sleeping well and reducing stress can all aid in your recovery.
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